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An Interview With An Informatics Nurse

Ever wonder how all those hospital systems are created and maintained? (Computer charting, systems to report data to national and state organizations, to name a couple.) Sure, they could hire some IT guy to run them, but everything seems to flow better with a nurse’s touch. After all, we’re the ones using them all the time, right?  Jen C, RN, BSN almost MSN gives us a look into the world of nursing informatics.

Jen has been doing this job for two years. She says she “stumbled into it” when she was interviewing for a new job and mentioned that she was starting her master’s in informatics. Although she was hired to be a staff nurse, within four months she was working in informatics.

What do you do all day?

Each day is different. I do a lot of troubleshooting. I go to a lot of meetings. I do system development and upkeep. I listen to the nurses and what their issues are with the various systems. I do education. And I still fill in at the bedside (I’m still a NICU nurse at heart.)

What frustrates you about your job?

Little definition and recognition as to what my job is. I often seem to be a catch-all. I also don’t have a mentor. I’m the only one in my hospital that has formal education in this area and only one or two in the whole hospital.

What about your job makes you proud to be a nurse?

I still affect patient care. If I do my job well, the nurses at the bedside can do a better job of taking care of patients.

Do you feel you receive adequate support for your responsibilities?

No. I have no backup. I’m essentially on call 24/7. And don’t get paid for that. I can’t accomplish all I need to do within the constraints of my hours — I work at home, too. I am paid hourly for now while I’m in school. I work four days a week for nine to 10 hours a day.

What do you get called about on your off hours?

Case in point was this weekend. On Thursday night I got a call from the L&D charge nurse. She told me that the patients weren’t appearing in the charting system they use. No one was moving out of the beds either, despite admissions doing it in their system. The charge nurse had already called the house supervisor who called IT and got nowhere — so they called me. I was able to troubleshoot over the phone and call the right person in IT directly. Yesterday another charge nurse called me that there were two charts for a patient, and asked if I could fix that.

What is something a nurse who does not work in your particular field might find surprising about your job?

I know more about evidence-based practice than most bedside nurses. You can’t expect staff to chart according to evidence-based practice if the charts don’t support it. Recently I had to change the way our lactation nurses charted to support the evidence. I’ve done similar things for our neonatologists and gynecology nurses. Often I find out about the changes and pass it on to staff (who usually have no idea).  I also know far more than I ever wanted to know about rules and regulations and core measures. I have to keep my clinical skills sharp. If I don’t do the above, I can’t build an effective system.

Does what you do involve a lot of teamwork, or is it more of an individual job?

It’s both. The actual building of a system is a one man job, BUT getting to that point requires teamwork. I also need the staff to work with me in order to meet their needs.

Was there any extra training besides on-the-job learning that you were required to complete for this job?

You need to be trained on the system(s) you work on. It does help to have formal education in informatics. I see a big difference between myself and those who have no formal education. You get the “big picture” with the formal education.

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

It depends. When the [s#*t] hits the fan then no, but most days yes. Eating is another story.

What is nursing informatics’ definition of “[s#*t] hitting the fan?”

This is a very geeky answer, so bear with me. One system I support runs on a primary and backup server. This past summer one server started to fail. In layman’s terms, the server is supposed to run on four wheels. We lost one, but it was ok to run on three wheels. In the middle of a very busy Sunday afternoon, the third wheel blew, killing that server.

It was a hairy couple of hours while we configured everything to run on the one server. (Since it was Sunday, I flew into the hospital to start dealing with it). Another time, one system wouldn’t talk to any other system and just froze up. It was our fetal monitoring system, so it was a crisis. I became very well-acquainted with tech support that day. We were down for roughly an hour (so no central monitoring for fetal monitoring).

Thanks to Jen for her explanations of what an informatics nurse does. Good thing we have someone on the IT inside.

*This blog post was originally published at code blog - tales of a nurse*

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